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General NPI Number Information
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NPI Number | 1861470296
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Entity Type | Individual
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Provider Name | MARK E REDMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 17400 W 13 MILE RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5439
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Country | US
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Telephone | 248-712-4120
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Fax | 248-792-5243
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Provider Business Mailing Address
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Address Line | 26901 BEAUMONT BLVD STE 3D
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3849
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 4301066003
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License Number State | MI
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